Individual
KENNETH W CHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18133 VENTURA BLVD STE 100, TARZANA, CA 91356-3641
(818) 933-2020
(818) 817-7668
Mailing address
18133 VENTURA BLVD STE 100, TARZANA, CA 91356-3641
(818) 933-2020
(818) 817-7668
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
G29660
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
G29660
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G296600
—
CA
Enumeration date
11/17/2005
Last updated
11/17/2023
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